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Pituitary Tumors

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What are pituitary tumors

Although rare, most pituitary tumors are non-cancerous (benign). However, because of the location of the pituitary gland, at the base of the skull, a pituitary tumor grows upward. And, eventually, most pituitary tumors press against the optic nerves, causing vision problems.

A tumor in the pituitary gland causes symptoms by either releasing too much of a hormone or by pressing on the gland causing it to release too little hormone. The symptoms experienced from the pituitary tumor are often determined by the type of tumor. A tumor that secretes hormones produces symptoms by releasing too much of the hormone.

Some tumors cause the gland to stop releasing enough hormones. In this case symptoms arise from lack of hormones. A pituitary tumor may also cause symptoms by growing and pressing on the structures, like the nerves to the eyes, surrounding the gland.

Pituitary Tumors

The most frequent cause of pituitary disorders is pituitary tumors. The pituitary gland is made of several cell types. Each cell type releases one of the hormones mentioned above. Sometimes these cells grow too much or produce small growths.

These growths are called pituitary tumors, and they are fairly common in adults. These are not brain tumors and are not a form of cancer. Cancerous tumors of this sort are extremely rare. Pituitary tumors can interfere with the normal formation and release of hormones, however. In addition, some pituitary tumors make too much of the type of hormone produced by the pituitary cells forming the tumor.




Pitutiary Disease Symptoms

Because the pituitary gland controls the production of hormones throughout the body, pituitary disorders resemble other endocrine disorders and have a broad range of symptoms.

Symptoms depend on the type and location of the tumor and cause hormone excess, hormone deficiency, or pressure on the brain and central nervous system.

Some tumors cause excess hormone production while others cause a deficiency, so one type of tumor may produce symptoms that are very different from those produced by another type of growth (for example, one may cause hair growth while the other causes hair loss).

The same tumor may begin by causing the release of excess hormone and then later result in a deficiency of that hormone as normal pituitary cells are suppressed. This would cause early symptoms that appear to be the opposite of later symptoms.

Some of the many symptoms associated with pituitary tumors include the following:
• Headache
• Visual changes
o Double vision
o Drooping eyelids
• Personality changes
o Decreased sexual interest
o Irritability
• Seizures
• Nasal drainage
• Skin changes
o Thickened skin
o Enlarged sebaceous glands
• Facial changes
o Moon face, puffy eyes
o Enlarged jaw and facial bones
• Hair changes
o Loss of body hair
o Coarse, thin head hair
o Thinning of eyebrows
• Weakness
• Lethargy
• Temperature sensitivity
o Intolerance to cold
o Intolerance to heat
• Constipation
• Nausea and vomiting
• Low blood pressure
• Impaired sense of smell
• Changes in weight
o Weight loss (unintentional)
o Weight gain (unintentional)

In women:
• Cessation of menses
• Abnormal nipple discharge
• Excessive body hair

In men:
• Breast development
• Impotence

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Pituitary Disease Treatment

Treatment is determined by the type of tumor and by whether it has invaded tissues adjacent to the pituitary gland.

Hormone-secreting tumors can be successfully treated with surgery, radiation, bromocriptine (Parlodel), Sandostatin (Octreotide), or other somatostatin analogues (drugs similar to somatostatin).

Surgery is usually used to remove all or part of a tumor within the gland or the area surrounding it, and may be combined with radiation therapy to treat tumors that extend beyond the pituitary gland. Removal of the pituitary gland requires life-long hormone replacement therapy.

Radiation therapy should not be used routinely for pituitary tumors. Damage to the remaining pituitary occurs frequently and may also cause blindness due to injury of the optic nerves. Individuals who have had their tumors resected are followed with yearly MRI and recurrences are treated with reoperation. Radation is reserved for those unresectable tumors that continue to grow.

Some pituitary tumors stabilize without treatment, but a neurosurgeon will operate at once to remove the tumor (adenectomy) or pituitary gland (hypophysectomy) of a patient whose vision is deteriorating rapidly.

Patients who have pituitary apoplexy may experience very severe headaches, have symptoms of stiff neck, and sensitivity to light. This condition is considered an emergency. Magnetic resonance imaging (MRI) is the best imaging technique for patients with these symptoms.

If the tumor is small, surgery may be done through the nose. If the tumor is large, it may require opening the skull for tumor removal.

Selected patients do well with proton beam radiosurgery (the use of high energy particles in the form of a high energy beam to destroy an overactive gland).

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